Anastomosis ileorrectal en el tratamiento quirúrgico de la colitis ulcerosa: resultados a largo plazo / Ileorectal anastomosis in the surgical treatment of ulcerative colitis: long-term results
Rev. méd. Chile
; 136(9): 1121-1126, sept. 2008. ilus, tab
Article
en Es
| LILACS
| ID: lil-497026
Biblioteca responsable:
BR1.1
ABSTRACT
Background:
Total colectomy with ileorectal anastomosis (IRA) is an alternative to the ileoanal pouch for the surgical treatment of ulcerative colitis in a selected group of patients. This technique leaves rectal mucosa Hable to develop persistent proctitis, dysplasia and cancerAim:
To describe short and long-term results of IRA and to assess the presence of dysplasia. Material andmethods:
Descriptive study of patients treated with IRA. The data were obtained from the clinical records, and the present status was evaluated with an interview. A proctoscopy and biopsy was offered free of cost to the contacted patients.Results:
Between 1978 and 2005, 26 patients were operated. One patient presented an anastomotic leakage that was treated with a loop ileostomy There was no operative mortality. Twenty-three patients were followed for a períod of 1 to 23 years. Three patients evolved as Crohn 's disease and two of them needed a proctectomy. Three patients died of non-related diseases. In the remaining 17, the average evacuation rate was 3.7/24 h and all were continent. None developed a rectal cancer Only two patients had their planned annual endoscopic surveillance. In 2 of the 11 patients who accepted endoscopy and biopsy, a low-grade dysplasia was found.Conclusions:
IRA has low morbidity and acceptable functional results in this selected group of patients. No patient present high-grade dysplasia or cancer; however, the adherence to the endoscopic follow-up ispoor.Palabras clave
Texto completo:
1
Índice:
LILACS
Asunto principal:
Recto
/
Colitis Ulcerosa
/
Colectomía
/
Íleon
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Child
/
Female
/
Humans
/
Male
Idioma:
Es
Revista:
Rev. méd. Chile
Asunto de la revista:
MEDICINA
Año:
2008
Tipo del documento:
Article